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General NPI Number Information
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NPI Number | 1376216911
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Entity Type | Organization
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Legal Business Name | ROSE HOSPICE INC
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Dates
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Enumeration Date | 07/29/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 8560 VINEYARD AVE STE 504
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4350
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Country | US
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Telephone | 909-757-0969
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Fax | 909-757-0991
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Provider Business Mailing Address
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Address Line | 8560 VINEYARD AVE STE 504
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4350
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Country | US
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Telephone | 909-757-0969
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Fax | 909-757-0991
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Authorized Official
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Title or Position | CEO
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Name | MARY-ANNE S NAMUCO
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Credential |
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Telephone | 323-767-4192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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